Medical Billing Forum

Starting a Medical Billing Business => Starting Your Own Medical Billing Business => Topic started by: ste on July 13, 2009, 11:14:10 PM

Title: Writing first proposal (happens to be a social worker)
Post by: ste on July 13, 2009, 11:14:10 PM

I am writing a proposal for a provider who sees 10 patients and each patient shows up once a week. The provider charges $80 to $140 per session and in the past has not accepted insurance. A couple patients have indicated they would like to have their insurance companies billed. Potential patients have shown an interest, but they would have to pay with insurance. The provider responded to an add I had mailed, explained the situation and said, "I need help".Charging 8% of money collected from claims will only give me approximately $75/month, assuming I file 2 claims per week and the insurance company pays the entire cost of the session. Antek HealthWare is going to charge me $250/month as a minimum fee. Other services I might be able to charge for include patient statements, setting up the provider with remote access, lots of monthly practice management reports. Do you think it's possible that I could just set a flat monthly fee (which the provider would accept) close to the minimum monthly fee that Antek will charge me?Steven

Title: Re: Writing first proposal (happens to be a social worker)
Post by: jcbilling on July 13, 2009, 11:31:04 PM

Steven,

Have you considered using Office Ally / Practice Mate for this client? www.officeally.com

They offer a nearly free clearinghouse and billing software that is web-based. They charge to have claims printed and mailed and also a $19.95 / month charge if over 50% of your claims are sent to government payers.

With my chiropractic clients, where reimbursement is not great, I have used them and have been very pleased. It's not as fancy as DAQ, but it gets the job done and with a such small workload, it's easy to manage follow-up and such.

I would be very hesitant about paying more overhead than what the client would be paying you.

Just my two cents :)

~ Charity

Title: Re: Writing first proposal (happens to be a social worker)
Post by: PMRNC on July 14, 2009, 06:37:12 AM

small providers are hard, you don't mention if the provider is new or established, that could make a difference because if you charge a flat fee you want it to be flexible to allow growth on her part and growth on yours as well. 8% on a Social Worker is high, but I understand this one is small. I'm not sure where you got 2 claims per week if she's seeing each of the 10 patients on a weekly basis?

10 patients a week is approximately $800 a week, $3200 a month. $3200 X .08% = $256.00 (based on $80)

What you could do is charge the provider 1/2 of the $250 with a clause in the contract that if her practices grows to XX.XX in reimbursements, this charge would then be fully picked up by your company.

Title: Re: Writing first proposal (happens to be a social worker)
Post by: ste on July 14, 2009, 02:19:40 PM

Only 2 of the 10 patients have insurance. The remaining 8 don't have insurance and pay by cash, check, or credit card.

Also your question leads me to think I might be missing something here. Do I get to charge a percentage of all money collected or just a percentage of money collected from Insurance companies? I am assuming it's the latter.

I could set up credit card processing capabilities, and perhaps charge a percentage of money collected?

Steven

Title: Re: Writing first proposal (happens to be a social worker)
Post by: PMRNC on July 14, 2009, 03:03:20 PM

Quote

Only 2 of the 10 patients have insurance. The remaining 8 don't have insurance and pay by cash, check, or credit card.

Also your question leads me to think I might be missing something here. Do I get to charge a percentage of all money collected or just a percentage of money collected from Insurance companies? I am assuming it's the latter.

I could set up credit card processing capabilities, and perhaps charge a percentage of money collected?

How you charge depends on what you put in your contract. You need to be specific. My rule of thumb is.. If I touch it, I get paid. If you will be posting all the payments, billing patients, and overseeing the practice receivables, YES you should get your full percentage on the total practice revenue, just be sure your contract states that. That is actually industry standard. Some providers will try and tell you they only want to pay you for insurance reimbursements but give them the logic.. If you are sending patient statements, and doing the practice reporting you should be compensated appropriately, there is only a difference in function (claims go to clearinghouse/payor and patient bills go to the patient). If they don't want to pay you for the work you are going to provide then walk away now or have a hard time later.

As for credit card processing, I wouldn't do it for this small practice and I am assuming you mean for the provider to pay YOU? Patient payments should go to the provider and if she wants to take credit cards that's something she should do, if you do it then you are getting into the realm of collections which is going to require a surety bond and that's a small provider to be going through all those things.

Title: Re: Writing first proposal (happens to be a social worker)
Post by: ste on July 14, 2009, 03:48:10 PM

Thanks Linda,I will forgo the credit card processing. Does 7% of ALL collected monies sound a bit high for a social worker?

Title: Re: Writing first proposal (happens to be a social worker)
Post by: PMRNC on July 14, 2009, 04:30:10 PM

7% sounds about right but you might want to do a bit more research for your area. I've had some small mental health providers in NY, NJ, CT, and MA and the % was 6-7% depending on where they were and other factors.

Title: Re: Writing first proposal (happens to be a social worker)
Post by: allgovbids on January 29, 2013, 10:12:43 PM

But i think before writing any proposal you should avoid mistakes that could result in a rejected or losing proposal :